MEDICARE: JAMES S. CAZILAS R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	35139	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	35139	OTHER	NY	3513935139

General Provider Information

NPI Number	:	1851569446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES S. CAZILAS R.PH.

Provider Business Mailing Address
First Line	:	4616 DOUGLASTON PKWY
Second Line	:
City	:	DOUGLASTON
State	:	NY
Zip	:	11362-1057
Country	:	US
Telephone Number	:	718-224-9855
Fax Number	:

Provider Business Practice Location Address
First Line	:	1757 CENTRAL PARK AVE
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10710-2828
Country	:	US
Telephone Number	:	914-961-2355
Fax Number	:	914-779-4071

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	02/15/2008

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